Bendale Acres deaths: Outbreaks at long-term facilities need to be made public, experts say

There is no mandatory public reporting of outbreaks in institutions beyond postings in the facilities themselves while the health threat is active. That should change, experts say.

A string of three disease outbreaks since 2010 at Scarborough long-term care home Bendale Acres caused five related deaths, a dozen hospitalizations and exposed 200 seniors to vomiting, dehydration and diarrhea.

The cases are carefully detailed in Toronto Public Health inspection reports obtained through freedom of information.

But they were never made public.

That’s because there is no mandatory public reporting of outbreaks in institutions beyond postings in the facilities themselves while the health threat is active.

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That should change, said Mansel Griffiths, director of the Canadian Research Institute for Food Safety and a professor in the department of food science at the University of Guelph.

“If people know that there’s been an outbreak associated with a particular organism and maybe a particular source of transmission, then I think that should be in the public domain,” he said.

“There should be a high degree of transparency . . . The final outcome of some of these outbreaks, it leads to (death).”

Doug Powell, a Canadian food safety expert, also believes outbreak information should be a matter of public record.

“All outbreaks should be documented so residents and their families can figure out if there are repeat offenders out there to stay away from.”

Margaret Aerola, Bendale’s administrator, said outbreaks in large facilities such as nursing homes are “very prevalent.”

“Outbreaks do happen,” she said. “We are dealing with people whose health status is already compromised so it does have a greater impact.”

There were 21 such outbreaks in long-term care facilities in Toronto last year, say city officials.

Aerola said Bendale posts notice of active outbreaks on the facility’s front door and reports to the city and the province.

As for disclosure of outbreak information to the public, she says: “We believe in transparency . . . If this became another indicator, this is something we’d move forward on. It’s not up to me to say that is the direction in which we should go, but it’s certainly something we’d participate in.”

In February 2010, a viral outbreak at Bendale led to 12 residents being hospitalized (for fever, numbness in one hand, diarrhea, not eating and dehydration) and four related deaths (two from pneumonia, one from complications and another from gastroenteritis “which was directly related to the outbreak”), a city outbreak report reads.

The first of two outbreaks at Bendale last year emerged in January, leaving seven residents ill with diarrhea and vomiting and 32 more “at risk,” says a city inspection report.

A second outbreak came only three months later, this one claiming 62 ill seniors, a hospitalization and a related death, the city outbreak report says.

All three outbreaks at Bendale — called norovirus — were attributed to person-to-person transmission.

Michael Finkelstein, associate medical officer of health at Toronto Public Health, said public disclosure of outbreaks isn’t something he has considered.

“I’d have to think more about the pros and cons of that,” he said. “It has the potential for linking the outbreaks to something that might be wrong with the facility in the mind of the public. But it can be very, very challenging for facilities to prevent these outbreaks from coming in . . .

“We need to work as close as we can with the facilities to continue to make them stronger to prevent or reduce the probability of these outbreaks.”
© The Toronto Star